Provider Demographics
NPI:1447200621
Name:ANESTHESIA ASSOCIATES OF LOUISVILLE, PSC
Entity Type:Organization
Organization Name:ANESTHESIA ASSOCIATES OF LOUISVILLE, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:LADEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-583-0909
Mailing Address - Street 1:332 W BROADWAY STE 810
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-2133
Mailing Address - Country:US
Mailing Address - Phone:502-583-0909
Mailing Address - Fax:502-583-0913
Practice Address - Street 1:332 W BROADWAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-2130
Practice Address - Country:US
Practice Address - Phone:502-583-0909
Practice Address - Fax:502-583-0913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65929994Medicaid
KY5168Medicare PIN